Availity is a healthcare technology company focusing on revenue cycle management. It started back in 2001, based in Jacksonville, Florida.
It began as a joint venture between Florida Blue and Humana, two big health insurers in the US. Russ Thomas leads the company as CEO today.
I find their mission pretty clear—they want to fix communication obstacles in healthcare. They enable real-time, accurate info exchange among health plans, providers, and tech partners.
Availity runs the largest real-time health information network in the US. It connects over 3 million providers to more than 2,700 health plans. They handle over 13 billion clinical and financial transactions every year.
The company employs several thousand people and plays a major role in healthcare tech modernization. They recently moved their entire application stack to Amazon Web Services.
That migration brought government-grade cloud security and sped up transaction processing a lot. In fact, claims are processed 87.5% faster than before the move to the cloud.
In this Availity review, I’m going to highlight their latest moves. For example, in May 2025, they teamed up with Salesforce.
Together, they launched new AI-driven solutions for healthcare workflows. This shows how Availity keeps adding next-gen technology into healthcare systems.
| Availity – Quick Overview | |
|---|---|
| What It Does | Provides a cloud-based platform for revenue cycle management and real-time healthcare information exchange connecting providers, payers, and technology partners. |
| Best For | • Healthcare providers (solo to large health systems) • Billing companies • Health plans • Health IT vendors needing real-time payer connectivity |
| Key Products | Availity Essentials • Availity Essentials Pro • Eligibility & Benefits Verification • AI-Powered Prior Authorization • Claims Management Suite • Remittance & Payment Solutions • Integration & API Services |
| Pricing | Core functions free for providers (Essentials) Custom pricing for Essentials Pro and enterprise plans starting from low hundreds/month No time-limited free trial but live demos and training available |
| Standout Features | • Largest real-time healthcare network in the US • Automated revenue cycle management tools • AI-driven prior authorization • Modern RESTful and FHIR API access • Government-grade cloud security via AWS |
| Integrations | Major EHR & practice management systems • Health plan portals • Clearinghouses • HIPAA X12, HL7, FHIR standards |
| Get Started | Start Free Trial → |
Availity Solutions
Availity offers a suite of cloud-based products designed to ease your administrative, clinical, and financial workflows.
Their tools serve healthcare providers, payers, and technology partners alike.
1. Availity Essentials
This is their flagship platform that acts as a central hub for tasks like eligibility and benefits checking, claims submission, and remittance.
It helps providers, payers, and vendors process transactions with payers across the country efficiently.
2. Availity Essentials Pro
This is an upgraded version built for larger organizations or users who want automation.
It comes with strong revenue cycle tools focused on denial prevention, management, and ensuring cash flow stays optimized. It’s ideal if you handle high claim volumes or work in enterprise health systems.
3. Eligibility & Benefits Verification
This tool lets you verify patient insurance eligibility, benefits, and coverage in real-time.
This can cut down on claim denials and save you from extra administrative work.
4. AI-Powered Prior Authorization
Availity is investing heavily in this newer area. They use artificial intelligence to automate and speed up prior authorizations.
This reduces care delays and clears administrative roadblocks. They’ve teamed up with companies like Salesforce to push this forward.
5. Claims Management Suite
Their suite includes tools to create, edit, submit, track, and report on claims electronically.
It helps smooth out the claim process, which means fewer write-offs and better reimbursements for you.
6. Remittance & Payment Solutions
This product centralizes electronic remittance advice and payment solutions.
It improves how you post cash and reconcile accounts, making these tasks easier and faster.
7. Integration and API Services
Availity offers modern RESTful and FHIR APIs to integrate easily with your EHR, practice management system, or other apps.
This enables automation and lets you build custom workflows that fit your specific needs.
Integrations
Availity works with most major EHRs and practice management systems.
It also connects to many health plan portals and clearinghouses.
Thanks to their modern API suite, it supports popular healthcare interoperability standards like HIPAA X12, HL7, and FHIR.
Availity Features
1. Largest Real-Time Healthcare Network
Availity connects over a million providers with more than 2,700 payers.
This setup facilitates billions of transactions every year. It lets you access the latest patient, payer and clinical info without juggling multiple logins or portals.
2. Revenue Cycle Management Automation
Availity handles eligibility checks, claim submissions, remittance advice, and denial management automatically.
This reduces manual work, speeds up reimbursement, and cuts down errors. It even flags denials and explains them so your team can fix issues quickly.
3. AI-Powered Prior Authorization
Using responsible AI, Availity streamlines prior authorization. This helps cut care delays and boost patient outcomes.
Automating this step removes one of the biggest blockers in specialty and high-cost care settings.
4. Modern API Access and EHR Integration
Availity offers RESTful and FHIR APIs that easily connect with health IT systems.
You can embed Availity’s transactions directly into your EHR, billing, or claims software. This saves time and improves data accuracy.
5. Robust Security and Compliance
Since moving to AWS and adopting cloud-native security, Availity meets strict U.S. government standards for security and operational resilience.
That’s vital for keeping HIPAA compliance and protecting sensitive patient data.
6. Comprehensive Mobile and Web Apps
Both web and mobile solutions let you check eligibility and claim status in real time.
Mobile access is great for providers who need to review transactions on the go or after hours.
7. Nationwide Coverage
Availity gives you direct access to the country’s largest payer-provider network.
This means your practice or organization can connect with almost every major health plan in the US through one platform.
If you’re looking for a tool that combines scale, real-time operations, and AI-powered features, Availity has you covered. It keeps improving speed, security, and functionality using cloud-native technology.
These Availity features make managing healthcare interactions easier and more efficient.
Availity Pricing Plans
Availity pricing can feel a bit unclear since they don’t publish detailed costs on their website. That makes sense because healthcare software pricing often depends on the size of your organization and the features you need.
If you’re a smaller provider, you’ll likely find the free Availity Essentials plan covers your basic billing and eligibility needs. But if you’re with a larger practice or health system, you will probably want the more advanced features found in the paid plans, which require getting a custom quote.
Here’s a simple breakdown of the main plans available.
| Plan | Price & Features |
|---|---|
| Availity Essentials | Free • Core functions like eligibility checks • Claims submission • Remittance advice |
| Availity Essentials Pro | Custom pricing – contact sales • Advanced automation • Analytics and reporting • Revenue cycle management features |
| Enterprise/Custom Plans | Custom pricing – contact sales • Integration for large health plans and IDNs • High transaction volumes • Tailored support options |
Availity lets you see live demos and offers training to get you up and running. There isn’t a limited free trial since the base plan is already free for many users.
If you want to explore or try it out, click here to learn more about Availity pricing →
Availity Alternatives
Here’s a quick look at how Availity stacks up against other players in healthcare connectivity and revenue cycle management.
You’ll find some important differences around pricing, features, and unique benefits.
Let me walk you through the key competitors and what sets Availity apart.
| Competitor | Their Strengths | Availity Advantage |
|---|---|---|
| Change Healthcare | Extensive claims clearinghouse and analytics | Offers a free plan and a massive nationwide payer network, plus API-driven integrations for easier connectivity |
| Kareo | User-friendly for small practices with Orange EHR integration | Typically less expensive for core RCM functions with strong free offerings for smaller providers |
| Waystar | Workflow automation and predictive analytics | Focuses on real-time data exchange and AI-powered automation, which can be more cost-effective depending on deployment |
| Experian Health | Patient access, revenue cycle management, and credit tools | More affordable for core features and offers robust free options tailored to smaller providers |
| Quadax | Niche clearinghouse with personalized support for specialty workflows | Supports real-time data exchange with AI-powered features and a large payer network at competitive pricing |
Availity provides real-time data exchange and AI-powered automation that many competitors don’t offer for free.
It’s especially strong if you’re a smaller provider looking for cost-efficient solutions with access to a broad payer network.
While some enterprise-level, feature-rich setups might cost more, Availity’s core revenue management functions tend to be less expensive in comparison.
Who Should Use Availity
1. Healthcare Providers
Availity fits well if you are a solo practitioner, part of a medical group, clinic, hospital, or health system. It helps you manage revenue cycles more efficiently and connect with payers easily.
Many organizations use it to cut down on manual work and speed up eligibility checks and claim submissions.
2. Billing Companies
If you run a billing company, Availity offers a strong clearinghouse solution.
It also provides tools to manage denials, which can save a lot of headaches and improve your cash flow.
3. Health Plans
Availity helps health plans communicate better with provider networks across the country.
This can make coordinating care and managing contracts smoother.
4. Health IT Vendors
For developers creating health IT platforms, Availity supports real-time connectivity and EDI integration.
This streamlines how your software talks to payers and other systems without delays.
Best fit scenarios
You should consider Availity if your practice or organization wants to cut manual revenue cycle work.
It also works great when you want to automate eligibility checks and submit or track claims electronically.
A single portal for interacting with most US payers is a big plus.
And if you develop health IT and need easy API integration, Availity fits the bill.
When to choose alternatives
If your organization operates outside the US or needs international connectivity, Availity might not meet your needs.
You might also look elsewhere if you require very specialized patient financial engagement or advanced analytics beyond standard revenue cycle management.
Finally, if you want a deeply integrated EHR/RCM bundle, like Kareo’s EHR suite, you may want to explore other options.
Bottom Line
Availity is a solid choice for revenue cycle management.
It offers a scalable, secure platform with broad health information exchange. Its free plan works well for small practices.
Large organizations get extensive automation and nationwide coverage. Plus, it supports modern API integration.
Key strengths include payer connectivity, AI-powered prior authorization, and government-grade security. Pricing for advanced features is not transparent, though. Also, it’s focused mainly on the US, so global use is limited.
I hope this Availity review has helped you see where it fits. If you want to explore it yourself, you can start a trial of Availity →.
